Acute aortic dissection can present with a variety of complaints. We present a case involving a man who complained of sudden upper abdominal pain and vomiting 12 hours ago. He was initially diagnosed as acute pancreatitis based on his history and blood work but on computed tomographic scan, also was found to have a Stanford type A aortic dissection. His dissection and pancreatitis was managed medically including tight blood pressure control and protease inhibitor administration. But the patient died of a cardiac arrest 14 hours later.

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